Device for the treatment of fractures, especially leg fractures

ABSTRACT

A jointed splint structure in which upper and lower leg portions are hinged together at the knee and a foot portion is mounted on the foot end of the lower leg portion and is adjustable axially of the lower leg portion. The foot portion includes a sandal engageable with the sole of the foot and the sandal has substantially infinite adjustment in the foot portion within predetermined limits. The lower leg portion is adapted for adjustably receiving brackets engageable with the ends of pins inserted laterally through the bone being treated so the bone is clamped to the splint structure during healing.

llnited States Patent imler [54] DEVICE FOR THE TREATMENT OF FRACTURES, ESPECIALLY LEG FRACTURES [72] inventor: Rudolf Bimler, Deichstrasse 9, 279 Cu):-

' haven, Gennany ['22] Filed: Nov. 4, 1969 21 Appl. No.: 873,954

[30] Foreign Application Priority Data FOREIGN PATENTS OR APPLICATIONS A Light Fracture Frame by E. W. Cleary, MD. The Journal of Bone & Joint Surgery, Vol. XXIV, No. 3, July 1942 Primary Examiner-Richard A. Gaudet Assistant Examiner-J. Yasko [57] ABSTRACT A jointed splint structure in which upper and lower leg portions are hinged together at the knee and a foot portion is mounted on the foot end of the lower leg portion and is adjustable axially of the lower leg portion. The foot portion includes a sandal engageable with the sole of the foot and the sandal has substantially infinite adjustment in the foot portion within predetermined limits. The lower leg portion is adapted for adjustably receiving brackets engageable with the ends of pins inserted laterally through the bone being treated so the bone is clamped to the splint structure during healing.

5 Claims, 16 Drawing Figures PATTED M28 m2 SHIT 1 UF 4 INVENTOR RUDOLF B IMLER PATENTEDMAR28 I97? 3, 651 .803

saw 2 0r 4 RUDOLF B/MLER PATENTED MAR 28 m2 SHEET 3 OF 4 FIG-5 54 82 INVE/VTUR RUDOLF BIMLE/i PATE HTED MR 2 8 m2 SHEET U UF 4 PEG-l2 FBGM FIG-I5 FIG FIG-i4 l N VENTOI? RUDOLF BIMLLR DEVICE FOR THE TREATMENT OF FRACTURES, ESPECIALLY LEG FRACTURES The present invention relates to a jointed or articulated splint arrangement for supporting broken bones, especially of the lower leg between the knee'and ankle, during knitting thereof and is particularly concerned with such an arrangement wherein the bone is supported and held fixedly in position for more efficient healing and to prevent deformities.

Splint arrangements for holding bones in the proper position are known and are in wide use. Bones Which arebroken in the leg, particularly the lower part of the leg, can be quite difficult to set and to hold in position during the healing period. Further, for proper knitting of the bone and to insure proper position and fonn of the leg after healing, the entire leg must be supported in the proper position. i

It is in particular connection with such a splinting arrangement that the present invention is concerned. The present invention represents a further improvement and advance over the U.S. Pat. No. 3,417,748 which is also concerned with a jointed splint structure of the same general nature as that with which the present invention is concerned.

The problems presented by fractures of the lower leg portion are particularly difiicult because of the difficulty of properly immobilizing and supporting the leg during healing of the bone and of the necessity, at least on occasion, of X-raying the leg to monitor the knitting process. Also, it is of importance to be able to permit joint movement during healing without disturbing the fractured region of the bone.

In the prior patent referred to above, there is shown a jointed splint structure that has proved to have considerable merit in connection with supporting the leg while holding the bone or bones in the proper position during knitting thereof. The splint structure of the above-mentioned patent, however, is lacking in having the complete adjustability desirable for such a splint structure and in permitting complete manipulation of all of the parts of the splint structure.

With the foregoing in mind, a primary objective of the present invention is the provision of an improved jointed splint structure of the nature referred to.

A further object of the present invention is the provision of a splint structure of the nature referred to having a foot supporting sandal portion which is capable of substantially infinite adjustment to adapt it to the foot of the patient.

Still another object is the provision of a jointed splint structure of the nature referred to which permits X-ray examination of the bone being treated at any time.

Still another object of the present invention is the provision of a jointed splint structure which permits axial pressure to be exerted on the bone held in place by the splint structure.

The foregoing objects of the present invention, as well as other objects and advantages thereof, will become more apparent upon reference to the following detailed specification, taken in connection with the accompanying drawings, in which:

FIG. 1 is a general view showing a patient fitted with a jointed splint structure according to the present invention;

FIG. 1a is a view looking down on top of the splint structure with the position thereof reversed end for end from that of FIG. I;

FIG. 2 is a side view of the splint structure drawn at enlarged scale with the splint structure oriented in its FIG. 1a position;

FIG. 3 is an elevational view, partly broken away, looking in at the foot support or sandal end of the splint structure, namely, from the left end of FIG. 2;

FIG. 4 is a section indicated by line IV-IV on FIG. 3 and showing a support member forming a part of the splint structure;

FIG. 5 is a view drawn at somewhat enlarged scale showing the foot support or sandal of the splint structure and the various'adjustments thereof;

FIGS. 6 through 8 are schematic views looking in at the bottom of the foot support or sandal showing various adjusted positions thereof;

FIG. 9 is a schematic view showing the manner in which a spike or pin is inserted through the heel portion of a patients foot;

FIG. 10 is a view showing adjustable side plates at the heel end of the foot support or sandal;

FIG. 11 is a schematic plan view showing a step in the setting of a broken bone;

FIG. 12 is a view like FIG. 11, but shows the bone set and supported by the splint structure;

FIG. 13 is a view looking in from the right side of FIG. 12;

FIG. 14 is a view showing the manner in which a bone being treated can be put in compression; and

FIG. 15 illustrates in perspective a clamp modified over that shown in FIG. 4.

BRIEF SUMMARY OF THE INVENTION The invention pertains to a jointed or articulated splint structurein which a first portion of the splint is adapted supportingly to engage the upper leg of a patient above the knee and a second portion adapted supportingly to engage the leg of a patient below the knee. These portions are jointed together at the knee.

Slidably mounted on the foot end of the portion for engaging the leg below the knee is a third portion comprising a foot support or sandal engageable with the patients foot for holding it at the desired angle to the lower leg portion. This sandal is fully adjustable in all directions and can be clamped in any adjusted position.

The support for the lower leg portion comprises a rail along each side of the leg portion and inverted U-shaped brackets can be adjustably mounted thereon for receiving and supporting spikes or pins extending through the bones being treated. The portions of the splint structure which might interfere with taking X-rays of the bones and, in particular, the U-shaped brackets, are made of a plastic material, such as Delrin, or glass fiber reinforced polyester resin, which is substantially transparent to X-rays. The plastic material can be employed in substantially any portion of the splint and represents a relatively inexpensive and easily sanitized material.

DETAILED DESCRIPTION Referring to the drawings somewhat more in detail, in FIG. 1 hospital bed 10 is provided with a standard 12 at the head end of the bed and a standard 14 at the foot end. These standards support a horizontal bar 16 extending therebetween which can carry a hand grip member 18 and a pair of spaced pulleys 20 over which is entrained a cord or cable 22 connecting a weight 24 with a bracket 26 connected to, or forming a part of, the splint structure at the knee joint.

The bar 16 is also adapted for supporting a support member 28 from which cords or cables 30 lead downwardly to a bracket 32 at the foot end of the splint.

Standard 14 may carry a pulley 34 over which is entrained cord or cable 36 leading from a weight 38 to the aforementioned bracket 32.

The splint structure proper, to be described in detail hereinafter, is generally indicated in FIG. 1 by reference numeral 40 and comprises, in general, an upper leg portion 42, a lower leg portion 44, and a foot portion 46.

Turning now to FIG. 1a, it will be seen that the upper leg engaging portion 42 comprises laterally spaced, preferably tubular, rails 48 with a curved or flexible leg engaging supporting member 50 extending therebetween. The lower leg engaging portion 44 also comprises laterally spaced rails, indicated at 52, and extending therebetween is the curved or flexible leg engaging supporting member 54. Rails 52 are parallel and tuular.

Rails 48 and 52 are pivotallyconnected at their adjacent ends in the region of the knee by pivots 56 and plates 58 and clamp nuts 60 are cooperable for fixing the upper and lower leg supporting portions 42 and 44 at any desired relative position of angular adjustment.

The rails 52 of the lower leg supporting portion are, as mentioned, tubular and at their ends opposite the pivots 56, namely, toward the foot end of the splints, slidably receive side rails 60 which support the foot engaging portion of the splint. Rails 60 can be clamped by clamp knobs 62 in any desired position of adjustment in rails 52 and when clamp knobs 62 are loosened, rails 60 are relatively freely slidable in rails 52.

The rails of the lower leg portion of the splint structure are also adapted for receiving one or more inverted U-shaped bracket members 64 which can be adjusted along rails 52 and clamped in position therealong. The brackets 64 carry on the side legs thereof laterally adjustable pin supporting assemblies 66 having clamp nuts 68.

As will also be seen in FIG. 4, the side legs of brackets 64 are slotted and the pin supporting assemblies 66 are slidable in the slots and can be clamped in adjusted position therein by clamp nuts 68. The body of each pin supporting assembly is bored and threaded to receive a respective screw 67 which has socketed inner ends and can be adjusted toward and away from each other to engage or release the opposite ends of a pin, known as a Steinmann pin 69. As many of the brackets 64 as are necessary can be mounted on the rails 52 as will be seen hereinafter and can be adjusted therealong and clamped in adjusted positions on the rails.

As will be seen in FIG. 4, each of the inverted U-shaped bracket members 64 at the ends of the legs comprise clamp means 122 adapted for embracing rails 52 and include wing nuts 124 whereby the clamp means can be loosened for adjustment, removal or mounting with the bracket members and tightened for fixing the bracket members to the rails 52.

The aforementioned side rails 60 of the foot portion of the jointed splint, as will be seen in FIGS. 10, 2 and 3, form a portion of a generally U-shaped bracket member 70 extending outwardly from the ends of rails 52. Member 70 is adapted for adjustably supporting the foot engaging member or sandal of the splint. In FIG. 2, it will be seen that the foot engaging or sandal member at 72 is in the form of a wood or plastic member contoured on the upper side to fit against the sole of the foot. The member can be contoured for either a right foot or a left foot.

Sandal member 72 has adjustably connected to the bottom thereof a plate 74 which may, for example, be of plastic material.

Plate 74, as will be seen in FIG. 5, has a longitudinal slot 76 therein and is adapted for being secured to sandal 72 in adjusted longitudinal positions therealong by a clamp screw 78. At its upper end plate 74 carries the ball portion 80 of a ball joint which includes the socket 82. Socket 82 has fixed thereto a guideway, or channel slide, 84 adapted for slidably engaging the end leg 86 of a U-shaped bracket member 88.

The bracket member 88 has side legs extending downwardly and at their lower ends being formed to receive the cylindrical extensions 90 of bracket members 92 located in the region of the ankle. Each bracket member 92 has a cylindrical leg portion 94 pivoted thereto at the end opposite extension 90 and adapted for being adjustably clamped to a respective side leg of bracket member 70 by clamp member 96 as seen in FIG. 2.

Each bracket member 92 also has a cylindrical leg portion 98 pivoted thereto and adapted for engaging the ends of the legs of a still further U-shaped bracket member 100. Bracket member 100 has clamp members 102 on the opposite side legs thereof near the outer end leg of the bracket adapted for adjustably securing bracket 100 to the slotted arms 104 which are pivoted at their lower ends to the side legs of bracket member 70 near the outer end leg thereof.

The outer leg which forms the closed end of bracket member 100 is adapted for slidably engaging the guide or channel slide member 106 to which is secured the socket portion 108 of a joint having a ball portion 110 secured to the lower end of the aforementioned plate 74.

The described construction of the support for sandal 72 permits substantially infinite adjustment thereof with respect to the rails 52 of the lower leg engaging portion of the splint so that the foot can be supported in precisely the proper position as to elevation and angularity.

Each of the ball joints referred to at the opposite ends of plate 74 on the bottom of sandal 72 can be locked in adjusted position by operation of a lock member 118 and each of the slide members 84; 106 can be locked in place on the end leg of the bracket member engaged thereby by operation of a second locking member 120.

The sandal 72 also comprises side plates 112 adjustable thereon longitudinally of the sandal and also pivotal on the sandal about pivotal on the sandal about pivot 114. Plates 112 are generally triangular with the wide portion toward the heel of sandal 72 and with the side portions being apertured at 116 for receiving a pin or spike extending through the patient's heel to hold the foot in place on the sandal.

The adjustability of the foot supporting member or sandal 72 is illustrated in FIGS. 6, 7 and 8 wherein FIG. 6 shows that the sandal member can be adjusted in the vertical direction on plate 74. This is accomplished by availing of lock member 78 and slot 76. In addition to lock member 78, screws 122 can connect the plate at its lower end to the sandal with slots 124 being provided to pennit adjustment of the sandal on the plate.

FIG. 7 shows how the slide or guide member 84 can be laterally adjusted on the end rail 86 of the bracket member 88 in order to adjust the sandal laterally or to tilt sandal 72 in the lateral direction.

FIG. 8 shows the manner in which sandal 72 can be adjusted about a pivot axis extending through the balls and forming portions of the ball and socket joints at the upper and lower ends of plate 74.

The setting of a fracture or broken bone by the use of the splint arrangement of the present invention is shown in FIGS. 11, 12 and 13. In FIG. 11, a bone in the lower leg 152 ofa patient will be seen to be broken at 154 and 156. The leg is placed in the splint and a pin or spike 158 is driven through the heel portion as shown in FIG. 9. In FIG. 9, a holder 160 is held against one of plates 1 l2 and has the pin 158 therein. An instrument 162 introduced through holder 160 is employed for setting the pin in place through apertures 116 and the heel 164 of the foot.

A further pin 166 is introduced through the upper portion 168 of the bone and is held at its ends by a bracket generally indicated at 170 and which is one of the bracket members identified at 64 in FIGS. 1a, 2 and 4.

Further pins 172 and 174 are introduced through the bone portion 150 near the opposite ends thereof. The bone is then manipulated into the proper position and brackets 176 and 178, corresponding to bracket 170 are mounted on the side rails of the lower leg portion of the splint and are adjusted to engage with the ends of pins 172 and 174.

By longitudinal adjustment of the brackets and of the foot portion of the splint, the broken regions of the bone can be brought into registration and adjustment of the sandal and will hold the foot in the proper position relative to the remainder of the leg.

The bone will be, thus, held throughout the healing process while the jointed splint will permit movement of the leg joints as necessary. Further, the leg is exposed for X-ray and manual examination as may be necessary.

FIG. 14 shows a manner in which resilient rubber-like elements 180 can be employed for placing a bone in compression. The elements 180 are connected between the foot portion of the structure and an upper portion of the splint structure for exerting axial compressive force on the lower leg portion. The clamp members 96 are, at this time, loosened. Such an arrangement is of advantage in treating breaks of the type indicated at 182 in FIG. 14 and which are difficult to splint and support in any other manner. The use of the resilient bands 180 provides for pulling the broken ends of the bone together and for closing hairline fractures.

Modifications can be made within the scope of the appended claims. Thus instead of the two-piece clamp 122, the hinged clamp 122A of FIG. 15 may be used.

What is claimed is:

1. In a jointed splint structure: a lower leg portion pivoted to the knee end of an upper leg portion and adapted for engagement with the leg of a patient below the knee, and a frame-like foot portion adjustably mounted on the foot end of said lower leg portion and adapted for engagement with the sole of the foot of a patient, in which said frame-like foot portion comprises first upper and second lower U-shaped support brackets having lateral legs on the side of a foot engaging member, therein adapted to engage the sole of a foot of a patient to support the foot, opposite the foot side thereof near the toe and heel end respectively of said foot engaging member, the toe and heel ends of said foot engaging member being adjustable by swivel joints, interposed between said toe and heel ends of said foot engaging member and said frame, along the end legs of said upper and said lower U-shaped support brackets.

2. A jointed splint structure according to claim 1, in which each said support bracket has longitudinal legs extending from the end legs toward the axis of the ankle of the patients leg, and means pivotally connecting the said ends of said longitudinal legs at the junction of said upper and lower bracket of said foot portion.

3. A jointed splint structure according to claim l, in which said frame of said foot portion comprises a third U-shaped bracket having an end leg at the extreme end of the splint structure on the opposite side of said foot engaging member from the foot side thereof and side legs adjustably telescopically engaging said side rails of said lower leg portion, and link means adjustably connected between said second lower support bracket and said third support bracket for supporting said second support bracket at desired angles in said frame of said foot portion.

4. A jointed splint structure according to claim 3, in which said foot engaging member comprises a sandal portion for engagement with the sole of the foot of a patient and a support plate on which the sandal portion is adjustable in the direction of the length of the foot, the foot engaging member end of said swivel joints being mounted on the side of said support plate opposite said sandal portion.

5. A jointed splint structure according to claim 3, in which said foot engaging member has side plates adjustably mounted on opposite sides thereof at the heel end and apertured for receiving the ends of a heel pin. 

1. In a jointed splint structure: a lower leg portion pivoted to the knee end of an upper leg portion and adapted for engagement with the leg of a patient below the knee, and a frame-like foot portion adjustably mounted on the foot end of said lower leg portion and adapted for engagement with the sole of the foot of a patient, in which said frame-like foot portion comprises first upper and second lower U-shaped support brackets having lateral legs on the side of a foot engaging member, therein adapted to engage the sole of a foot of a patient to support the foot, opposite the foot side thereof near the toe and heel end respectively of said foot engaging member, the toe and heel ends of said foot engaging member being adjustable by swivel joints, interposed between said toe and heel ends of said foot engaging member and said frame, along the end legs of said upper and said lower U-shaped support brackets.
 2. A jointed splint structure according to claim 1, in which each said support bracket has longitudinal legs extending from the end legs toward the axis of the ankle of the patient''s leg, and means pivotally connecting the said ends of said longitudinal legs at the junction of said upper and lower bracket of said foot portion.
 3. A jointed splint structure according to claim 1, in which said frame of said foot portion comprises a third U-shaped bracket having an end leg at the extreme end of the splint structure on the opposite side of said foot engaging member from the foot side thereof and side legs adjustably telescopically engaging said side rails of said lower leg portion, and link means adjustably connected between said second lower support bracket and said third support bracket for supporting said second support bracket at desired angles in said frame of said foot portion.
 4. A jointed splint structure according to claim 3, in which said foot engaging member comprises a sandal portion for engagement with the sole of the foot of a patient and a support plate on which the sandal portion is adjustable in the direction of the length of the foot, the foot engaging member end of said swivel joints being mounted on the side of said support plate opposite said sandal portion.
 5. A jointed splint structure according to claim 3, in which said foot engaging member has side plates adjustably mounted on opposite sides thereof aT the heel end and apertured for receiving the ends of a heel pin. 